▫️تشخيص الحالة

🌐Germ cell testicular neoplasm

💎-The most common Testicular neoplasms 95%

💎-من اسمها فهي ناشئة من germ cell

💎- more common in younger men (15→35  years old)

💎-almost all are malignant.

💎-مشهور في اصحاب البشرة البيضاء اكثر من السوداء


🎐Risk factors include:

1| cryptorchidism (undescended testis)
اي انها مانزلت ظلت في الabdominal cavity  وهذا يزيد نسبة الrisk من ٣ الى ٥ اضعاف
وتوجد تقريباً بنسبة ١٠٪ من حالات testicular cancer

2\ Intersex syndromes:  مثل
-androgen insensitivity syndrome
-gonadal dysgenesis,

3\familial
لذلك اخذ القصة المرضية مهم جداً ،كوجود  أخوة ذكور يعانون من
germ cell tumors.
وهذا يزيد الــ risk بنسبة من٨ إلى ١٠ أضعاف 

4\ The development of cancer in one testis
وجود cancer  في testis المقابلة يزيد من risk.

🔖Notes

🧷point mutations that create oncogenes are relatively rare in germ cell tumors.


🧷Most testicular tumors in postpubertal males arise from 
germ cell neoplasia in situ.

🧷abnormality of chromosome 12(isochromosome12)  that is characteristic of fully developed germ cell tumors.
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

🎐Testicular germ cell tumors are subclassified into

①seminomas
②non-seminomas


🖌Seminomas:

are most common, accounting for about 50% of testicular germ cell neoplasms.
وتستجيب للأدوية بشكل كبير ويحصل لهاmetastasize  متأخر ولها prognosis جيد جداً
🖌nonseminomas
وتسمى بال teratomas
➱ 45٪of cases
تختلف من حيث استجابتها للأدوية
ويحدث لها metastasize مبكراً.



They are histologically identical to tumors called dysgerminomas,

نجي الآن إلى الاعراض السريرية C/F:

1_ painless testicular mass(lump)
وتكون:
-none tender
-hard
-irreguar
-arise from testicles

2_ testicular pain ممكن يظهر الم مفاجئ

3_gynaecomastia
ممكن تظهر بنسبة 2%

🎐metastasis:

3L 1B
ممكن يحدث انتشار للسرطان للأماكن التالية
1-lymph node
2-lung
3-liver
4-brain

🎐Investigation

(1)scrotal ultrasound
(2)tumor markers

➱alpha-fetaprotein
يرتفع في  الteratomas مش في seminomas
➱beta-HCG
يرتفع في both

➱(LDH) lactate dehydrogenase
ويعتبر  very non specific

(3)staging CT scan
ونستخدمها ل..
~look for spread & stage

🎐Management

① depending on stage
② Surgery to remove testicle
وتسمى العمليه ب (radical orchidectomy)
③ Chemotherapy
④ Radiotherapy
⑤ Sperm banking to save the sperms

🎐Prognosis

➱Early testicular cancer has good prognosis >90٪  cure

➱Seminomas has better prognosis  than nonsemanomas


والسلام عليكم 🤍✨

#اللجنة_العلمية_للدفعة_الخامسة
#قسم_الباثو
#patho_in_Clinic

A 32-year-old woman comes to the physician because of a 1-week history of left flank pain and dysuria. She has had 2 episodes of urinary tract infection over the past 2 years. Her temperature is 37°C (98.6°F) and pulse is 82/min. An ultrasound of the kidneys shows left-sided hydronephrosis and echogenic foci with acoustic shadowing. A photomicrograph of the urine is shown. The crystals observed are most likely composed of which of the following?

1)Uric acid

2)Cystine

3)Calcium oxalate

4)Calcium phosphate

5)Magnesium ammonium phosphate


@Patho_5th_bot

خليفه 👆🏻
#reproductive

Renal Stones ( Urolithiasis)

لنتعرف أولاً على أشهر الأمراض التي تُصيب الكِلى ألا وهو التحّصـي البولـي🤓

⚫️ Def. : is calculus formation at any level in the urinary collecting system, but most aften calculi arise in the kidney.
بمعنى تكون حصى في أي مستوى من الجهاز البولي والذي غالباً ما يكون في الكِلـى🧐

*وهل تعرفون من هم الغالبية العُظمى من المصابين؟
غالباً ما يكونون من الرجال البالغين 70 عاماً من العمر🥸


⚫️ Pathogenesis :

*There are three major types of renal stones:
1)Calcium oxalate or calcium oxalate mixed with calcium phosphate ( 80% ) due to : a) absorptive hypercalciuria
b) renal hypercalciuria

2)Magnesium ammonium phosphate "struvite1" ( 10% ) due to persistently alkaline urine resulting from UTIs.

3)Uric acid or cystine stones ( 6% _ 9%) due to Gout and diseases involving rapid cell turnover & defect in renal transport of cystine.


⚫️ Risk Factors :
شيءٌ مهم جداً يجب أن نتنبه إليه وهو العوامل التي قد تعرّضك للإصابة بالتحصّي الكلوي وهي 🤯 :
1)High amount of stone substance in blood :
   *Hypercalcemia
   *Hyperuricemia
2)Low urine volume :
    *Usually from dehydration
    *Increases con. of urine substances
3)In general, hydration lower risk of stones

⚫️ Morphology :

* Most commonly are Unilateral (80%)
* Common sites : renal pelvis and calyces and the bladder
* Staghorn calculi : large radiopaque urinary stone that fills the entire renal pelvis and calyces


⚫️ Clinical Features :

1) Large stones : usually asymptomatic
2) Smaller stones : manifest as renal or ureteral colic and gross hematuria .

#قسم_الباثو
#اللجنة_العلمية_للدفعة_الخامسة
#patho_in_Clinic

〄 A 54-year-old male, who is a chronic bidi smoker, presented with a painless ulceroproliferative growth over the glans penis of 6 months’ duration.

The examination revealed an exophytic growth over the glans penis measuring 3 × 2 cm over the superior aspect of the glans and under the surface of the prepuce (Figure 3).

Dermoscopy showed white structureless area, white clods, blood spots, erosion, and polymorphic vessels

Histopathology in this case was consistent with moderately differentiated squamous cell carcinoma (SCC).

The definitive diagnosis of this condition is...

1\lymphomas

2\cryptorchidism

3\scc of penis.

4\Germ cell testicular neoplasm

@Patho_5th_bot

تفريغات سامح غازي 👌🏻✨🤩

🔘تشخيص الحالة

🔵 Squamous cell carcinoma of penis

🔹- the most common neoplasm in penile, more than 95%

🔹-Most cases occur in uncircumcised patients(males) older than 40 years of age.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~
✎factors have been implicated in the pathogenesis:

1-poor hygiene
2-smoking
3-infection with HPV.
~ ~ ~ ~ ~ ~ ~ ~ ~ ~
⭐️Squamous cell carcinomaممكن  تكون ↓↓
1- in situ.
2-invasive.

✨Squamous cell carcinoma in situ of the penis
وتسمى ←(Bowen disease)

➱occurs in older uncircumcised males

✎ appears grossly as:

➱ a solitary plaque on the shaft of the penis.


✎Histologic examination:

reveals dysplastic cells throughout the epidermis with no invasion of the underlying stroma 


💡ملاحظة:
☆ It gives rise to invasive squamous cell carcinoma in 
approximately 10% of patients.


✨Invasive squamous cell carcinoma of the penis

✎ appears as: 

➱a gray, crusted, papular lesion,

➱most commonly on the 
glans penis or prepuce.

In many cases, infiltration of the underlying connective tissue produces an indurated, ulcerated lesion with irregular margins .


✎Histologically,

the tumor is most often a typical keratinizing squamous cell carcinoma.

💡Notes:

❐ The prognosis is related to the stage of the tumor.

❐With localized lesions, the 5-year survival rate is 66%,

❐ whereas metastasis to inguinal lymph nodes carries a grim 27% 5-year survival rate.
_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-


💫 Verrucous carcinoma

is a non-HPV related variant of squamous cell carcinoma

✎characterized by:

➱papillary architecture,

➱virtually no cytologic atypia,

➱ and rounded, pushing deep 
margins.

💡كملاحظة:
Verrucous carcinomas are locally invasive but do 
not metastasize.

-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-
▫️كيفية تشخيص الcancers of penis بشكل عام..
1-present of ulcers in penis
(tip, head, or glans)

2-swelling in the tip of the penis

3-sometimes there is difficulty of passing of urine.

▫️ولمعرفة ال stage of this cancer :
1)MRI
2)ST scan
3)PET scan

_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_
▫️عندما ينتشر السرطان الى الأعضاء المجاورة او البعيدة او  LN ↓↓

➱Chemotherapy
➱radiotherapy

▫️if the cancer extend   whole of the penis ➱ surgery remove  of the penis  (penectomy)




والسلام عليكم 🤍🦋

#قسم_الباثو
#اللجنة_العلمية_للدفعة_الخامسة
#patho_in_Clinic

Clinical case:

A 37-year-old primigravida with unknown last menstrual period and 20 weeks gestation by ultrasound presented with a history of headache, fever, vomiting and new-onset of convulsions. At the time of her admission the full blood count instrument at our hospital was out of service. A rapid blood test for malaria was positive. After an initial blood pressure of 164/127 and 3+ proteinuria on urinary dipstick?
She has malaria, so what's your prediction about illness's progression in this case???

@Patho_5th_bot